ZR6-16172-79701
2 vaccinations
4 coded responses
16 check-ins
4 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 51-55
- ZIP prefix
- 484 / MI
- Registered
- 2021-01-14
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-14
Registered in v-safe
-
2021-01-14
Dose 1 — Pfizer-BioNTech
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2021-01-14
Survey response — day 0, dose 1MedDRA: Dizziness, Feeling abnormal — Feeling: GoodFree text: Mild. Foggy or light headed. Possibly from anxiety about the shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-15
- 2021-01-16
-
2021-01-17
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Fatigue or tiredness, Abdominal painAdult check-in
- 2021-01-18
- 2021-01-21
-
2021-01-28
Survey response — day 14, dose 1MedDRA: Blood pressure increased — Feeling: FairFree text: Blood pressure increase.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-02-04
Dose 2 — Pfizer-BioNTech
-
2021-02-11
Health check-in — day 7, dose 2Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal painAdult check-in
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2021-02-18
Survey response — day 14, dose 2MedDRA: Chest pain, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultationFree text: Symptoms: Shingle like pain in right side of chest. · Healthcare visit (other): Haven't scheduled appointment but will.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-02-18
Report sent to call center — day 14, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-02-25
- 2021-03-04
- 2021-03-12
- 2021-03-20
- 2021-05-06
- 2021-08-07
-
2021-08-09
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2022-02-04
Survey response — 12 months, dose 2MedDRA: Back pain, Immunisation reaction, Pyrexia, Rash — Feeling: Fair · Be unable to do your normal daily activitiesFree text: At two weeks after my booster I developed symptoms consistent with COVID. Fever 102, moderate muscle ache of lower back and suspected rash. All resoved on day 5 afterwards. Two negative PCR tests during that time. Vaccine/immune reaction or undetecteMedDRA releases: 2024-11 · check-in free text available
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-14 | Pfizer-BioNTech | |
| 2 | 2021-02-04 | Pfizer-BioNTech |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-02-18 | Successful 2021-08-09 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 2 — day 0, dose 1
Systemic reaction (other): Mild. Foggy or light headed. Possibly from anxiety about the shot.
Release 2 — day 14, dose 1
Symptoms: Blood pressure increase.
Release 4 — day 14, dose 2
Symptoms: Shingle like pain in right side of chest.
Healthcare visit (other): Haven't scheduled appointment but will.
Release 11 — 12 months, dose 2
Symptoms: At two weeks after my booster I developed symptoms consistent with COVID. Fever 102, moderate muscle ache of lower back and suspected rash. All resoved on day 5 afterwards. Two negative PCR tests during that time. Vaccine/immune reaction or undetecte cut off by CDC
Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".
MedDRA terms by release
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| HCVO | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Back pain | · | · | ✓ |
| SD | Blood pressure increased | ✓ | ✓ | ✓ |
| SD | Chest pain | ✓ | ✓ | ✓ |
| SD | Immunisation reaction | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Rash | · | · | ✓ |
| SRO | Dizziness | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release